Hey Annie-

I do have to say that after looking at what your face is starting to look like now and comparing it to before you began your treatments, you are definately getting a good improvement. I actually am just off of my 4th treatment and may get a possible 5th. I really wish you the best of luck and hopefully we will both get great results in the end.

Weho

Congrats on your improvement. Ironically, I have the same deal; shallow on right side, deeper and more extensive on left.

The people at high energy are using the lower density setting of 125. Using density of 250, rather than 125, means you are getting twice the energy for a given energy level, so I actually think 16mj at 250 would hurt way more than my 20mj at 125. How many passes?

Any comments on enlarged pores vs scars improvment, etc?

Thanks

Weho

Congrats on your improvement. Ironically, I have the same deal; shallow on right side, deeper and more extensive on left.

The people at high energy are using the lower density setting of 125. Using density of 250, rather than 125, means you are getting twice the energy for a given energy level, so I actually think 16mj at 250 would hurt way more than my 20mj at 125. How many passes?

Any comments on enlarged pores vs scars improvment, etc?

Thanks

 

Yah I would like to know and the scar improvments. I hope this is my answer to my scars.

HMM...haven't really understood what exactly people mean by "passes". She went up and down, the same area, then crossed over the areas the other way twice....4 ???. She went over my left cheek an extra pass...6??

I don't have enlarged pores....well at least i don't think so. Aside from the scarring, they look pretty normal. i get facials every month and glycolic peels to help control the acne so maybe that helped..??? I do have a handleful of "scarred pores" (or tiny ice pick scars) that I read people talking about on the board. One on my forehead (the only acne scar there) and 2 on my nose. I didn't see any improvements on these.

So I wanted to ask everyone....... the day after my last treatment, my allergies started acting up. I didn't want to take anything because I didn't want any complications with the healing. Two day's later I couldn't take it anymore and called my Dr about taking allergy Rx. She told me it was OK and it would actually help with the redness. I took an Alegra D yesterday and I was surprised it really helped. My skin is flaking off and in the past I'd be a bright red for a few days. It's not that bad this time just pinkish. Just wondering if someone was ever prescribed anything like this before. If I knew about it I would have taken the Rx a few days after each treatment to reduce the red. Would have saved me alot of explaining to friends and coworkers about the sun burn in the winter.

Weho

 

Congrats on your improvement. Ironically, I have the same deal; shallow on right side, deeper and more extensive on left.

 

The people at high energy are using the lower density setting of 125. Using density of 250, rather than 125, means you are getting twice the energy for a given energy level, so I actually think 16mj at 250 would hurt way more than my 20mj at 125. How many passes?

 

Any comments on enlarged pores vs scars improvment, etc?

 

Thanks

 

Annie

More importantly, I think you are getting an excellent benefit. Thanks for sharing. Your album is a hoot. I feel guilty for not sharing pictures from my experience to date, but I'm older than most and not into the photo stuff. Also, there are a few hotheads on this site whose unfettered anger scares me a little. I plan to post my "before and after" a couple months after my last Fraxel. I am reasonably happy from my first 2 treatments, especially #2, so I have high expectations from #3 and # 4.

I also have a slight raccoon eyes from treatment. This is the only place that I have a residual demarcation that bothers me. Has yours resolved?

 

Hello Billyboy,

Thank you for your positive outlook and compliment. As for sharing photos, I'm no spring chicken and technically might be pushing 36 this summer but I wanted step by step proof that Fraxel worked. I have NO demarcation line. It looked really bad in person, but my coloring has a nice, sun kissed glow to it today. Regarding the racoon look you know you can ask the girl to apply the blue dye all the way to your eyelash line - of course if its OK with your Doctor.. I didn't do it this time, but the next 2 I will remember to ask. I want new collagen, in every crack and crevice. Now I'm wondering if I could get some blue dye on my lips.. 😀

It amazes me how Fraxel has evovled over the past two years. even at these super high laser levels fraxel is still much safer then c02 resurfacing and is still far more mild. Even if you are red for a week that beats looking like a tomotoe for several months after c02. I do think many people will see 50% improvements to even severe scars at these levels but I will hold off on 75% that sounds a bit to good to be true! LOL

Good luck and keep us posted. After my rounds of scultra I may go in at the end of the year for a round of two of fraxel touch ups and may consider doing them at these levels.

Tim

Right now my Fraxel/sculptra improvments have me around 40% for my worst scars. I do want to hit that majic number of 75% where I feel almost all of us would FORGET we ever had Acne! 🙂 should I keep dreamin?

 

I hear you. I had Co2 laser years and years ago. I was red for a year and truly my face was never the same. I was happy with my Doctor and after looking at the BEFORE photos he took, I was convinced the C02 changed my skin for the better. It removed layers and layers of skin - but at an emotional price. i never saw such a horrific site in my life as I did when I looked at my reflection in the mirror the next day. :ninja:

To be reaching these kinds of results with only a few days downtime with Fraxel is remarkable!! I would never do CO2 again - once yes - twice never.

Dreams keep us going - and you acted on them - so don't stop!

Hey Annie-

I do have to say that after looking at what your face is starting to look like now and comparing it to before you began your treatments, you are definately getting a good improvement. I actually am just off of my 4th treatment and may get a possible 5th. I really wish you the best of luck and hopefully we will both get great results in the end.

 

Hi natali,

I was wondering what happened to you. Thank you for compliments. How has it been going for you? How far apart did you space your treatments? How strong did he go? :wavey:

Thanks Annie for all the info and especially for sharing the photos.

 

Your welcome and thank you for sharing your story. Did you do anything special for those blisters? How long did it take for that area to look better?

So I wanted to ask everyone....... the day after my last treatment, my allergies started acting up. I didn't want to take anything because I didn't want any complications with the healing. Two day's later I couldn't take it anymore and called my Dr about taking allergy Rx. She told me it was OK and it would actually help with the redness. I took an Alegra D yesterday and I was surprised it really helped. My skin is flaking off and in the past I'd be a bright red for a few days. It's not that bad this time just pinkish. Just wondering if someone was ever prescribed anything like this before. If I knew about it I would have taken the Rx a few days after each treatment to reduce the red. Would have saved me alot of explaining to friends and coworkers about the sun burn in the winter.

 

OMG - I soooo am going to be on this next time. I don't like to take any allergy RX I have because it always drys me out. BUT - I will if it helps the process. I wonder how it can help with the redness? My biggest problem is the swelling but I'm sort of over it.

So I wanted to ask everyone....... the day after my last treatment, my allergies started acting up. I didn't want to take anything because I didn't want any complications with the healing. Two day's later I couldn't take it anymore and called my Dr about taking allergy Rx. She told me it was OK and it would actually help with the redness. I took an Alegra D yesterday and I was surprised it really helped. My skin is flaking off and in the past I'd be a bright red for a few days. It's not that bad this time just pinkish. Just wondering if someone was ever prescribed anything like this before. If I knew about it I would have taken the Rx a few days after each treatment to reduce the red. Would have saved me alot of explaining to friends and coworkers about the sun burn in the winter.

 

Yeah, 3 days post treatment, my skin was starting to itch (healing process and dry skin, etc.) so I took a benedryl to help with the itchiness and it helped. It didn't take away the redness or the dryness, just the itchy feeling.

Weho

Your understanding of pass is the same as mine. Up and back down is 2, a horizonaatal pass back and forth woudl be another 2. It sounds like you had 4 passes on most areas. So, compared to my treatment of 8 passes @ 20mj and 125 density, your coverage was idnetical to mine (4 x 250 = 8 x 125). However, i got more energy from 20 vs your setting of 16.

The one I don't understand is Blaster. How are you surviving that much pain from the thermal injury? Are you getting injections or are you world's toughest guy? In any event, you should be getting a great result. Have you had any permanent complications from these high settings?

Hi,

Before undergoing the 3rd treatment I was taking two panadene pain-killers + numbing cream + local anaesthtic injections into my face. There was some pain experienced during treatment but I felt it was tolerable. The pain was definitely less than my first treatment at 20mJ x 6passes x125 desnsity which I found to be quite painful. Perhaps this is due to desensitization.

After the themal injury I was feeling like my face was hot, but that subsided after 3-4 hours. Anyway it's been two days now and I don't experience any pain from my face. My skin is rough and very red, but aside from that there's no real discomfort. I think using a density of 125 may have something to do with that. My treatment is definitely one of the more aggressive, but seeing how I am 30 years old and my scarring is severe (cystic acne since I was 12) I feel that I would require stronger energy levels to get a response. (Collagen production reduces with age.)

From what I understand these settings are not that uncommon, and so far I have had a bit of hyper-pigmentation but I am taking a bleaching lotion to minimise this and it seems to be working. At Dr Skin clinic in Melbourne they regularly treat patients at level 25 and above for acne-scarring. This is in line after the recent Boston conference in March 06 where they presented the results of fraxel and found that the response for acne scarring was better at higher energy levels due to the collagen remodelling. Previously they were treating at a minimum of level 20 as standard, but after the conference, level 25 became the new standard as of this month.

I am very much looking forward to ending this treatment because of the down-time and the discomfort during treatment. After 5-6 treatments I will be done, and will not be carrying out any future scar treatment beyond this. I will take whatever result I can get and move on. No sense for me, obsessing and investing time and money in other treatments.

After 5 treatments I am hoping to get at least 50% improvement. My concern now is that ice-pick scars don't seem to respond as well, so I may ask for spot-treatment in my next fraxel at level 35.

I guess time will tell, and perhaps the final result is still at least 3 months away. My treatments are spaced at 5 weeks apart. My last treatment will be in August and my final result should be seen by Christmas this year.

Blaster

Weho

Your understanding of pass is the same as mine. Up and back down is 2, a horizonaatal pass back and forth woudl be another 2. It sounds like you had 4 passes on most areas. So, compared to my treatment of 8 passes @ 20mj and 125 density, your coverage was idnetical to mine (4 x 250 = 8 x 125). However, i got more energy from 20 vs your setting of 16.

 

The one I don't understand is Blaster. How are you surviving that much pain from the thermal injury? Are you getting injections or are you world's toughest guy? In any event, you should be getting a great result. Have you had any permanent complications from these high settings?

 

Just out of curiosity....does anyone know what is the maximum limit on the energy level of Fraxel and how much depth that corresponds to ? Fraxel literature says it can go as deep as 700 microns.

Hey Annie-

I do have to say that after looking at what your face is starting to look like now and comparing it to before you began your treatments, you are definately getting a good improvement. I actually am just off of my 4th treatment and may get a possible 5th. I really wish you the best of luck and hopefully we will both get great results in the end.

 

Blaster

Thanks for info. Do you know how to access the paper presented to March 06 conference in Boston? Or, any other recent studies of Fraxel on acne scarring. I was told by Dr Zakia Rahman (Fraxels' medical consultant) that she would be presenting a paper on acne scarring, also in March. However, when I google, I never find any recent studies on Fraxel efficacy and protocols for acne scarring. I would love to read these papers.

My improvemnt to date is so subtle, that it is hard to get too excited, but I think it takes time. Moreover, my first treatment was a waste at such low energy levels, other than as a test to see if I could tolerate procedure. I am waffling between 23 and 25 for # 3. I guess your advice would be 25. My scars are shallow though, so I may be better off at 23 with more passes. The Laser Center I am going to is a big spa that has every laser imaginable (and is less expensive than in SF), but I don't think they have much experience with acne scarring, so I feel I need to be assertive on what is best for me. By the way, I am happy with my choice so far. To be honest, I don't think many people in CA have acne scarring, so maybe not that many places have expertise here.

Hey Annie,

My BIG mistake was doing nothing for the blistering. I was left with hyperpigementation and a slight scar. It was too late to do anything about it when I went in for my follow-up because it had healed already. Of course she tells me I should have called her ASAP. All the Doc could do was give me bleaching cream and offer to touch it up. As the discoloration faded it started to look much better but when the lighting is right, you can see a texture change across my temple.

I'm hoping the touch-ups will take care of that. After treatement 4 she sent me home with some steriod cream and told me if I experience any blistering after the treatment to put the cream on over the area. Thankfully I had no other blistering.

Thanks Annie for all the info and especially for sharing the photos.

 

Weho

I know nothing about Alegra or the issue you raise, but I will venture a guess. Alegra is an antihistamine, that in effect, suppresses the body's overactive immune response. Swelling, inflamation and redness are symptoms of the body's immune resonse to the thermal injury. I don't recall any Fraxel literature or post op instructions cautioning against antihistamines, so you may have found something that is a win-win. To be safe, ask your Doc, because you would not want to take something that suppresses symptoms, but also suppresses the healing.

While the vast majority of docs don't buy this, there is a branch of medicine called prolotherapy. It's main premise is that one can promote healing of tissue by introducing agents that promote inflamation and swelling; namely, the body's natural healing response. I don't buy it either, but I do think that normal swelling and redness in response to Fraxel shows your body is working right.

Thanks Billyboy...

I thought about this also. I was worried that the Alegra would throw a wrench into my recovery (swelling) but I was desparate. I was a big mess and couldn't handle the allergies anymore. When I started the therapy my Doc also recommended ibuprofen (advil) but I was weary about this because ibuprofen also reduces swelling. I've only taken it an hour before my treatements to help me with the discomfort. Anyhow, I didn't think of asking my Doc about any hampering effects of taking the antihistamine. I do feel 100% times better now. My skin has flaked off completely. I'm still slightly swollen but my texture and skin tone look great. My right cheek is smooth and I need to be in the right lighting to see the scars on my left side. Wish it would stay this way..

Well thanks for the info and good luck!

Weho

I know nothing about Alegra or the issue you raise, but I will venture a guess. Alegra is an antihistamine, that in effect, suppresses the body's overactive immune response. Swelling, inflamation and redness are symptoms of the body's immune resonse to the thermal injury. I don't recall any Fraxel literature or post op instructions cautioning against antihistamines, so you may have found something that is a win-win. To be safe, ask your Doc, because you would not want to take something that suppresses symptoms, but also suppresses the healing.

 

While the vast majority of docs don't buy this, there is a branch of medicine called prolotherapy. It's main premise is that one can promote healing of tissue by introducing agents that promote inflamation and swelling; namely, the body's natural healing response. I don't buy it either, but I do think that normal swelling and redness in response to Fraxel shows your body is working right.

 

Blaster

Thanks for info. Do you know how to access the paper presented to March 06 conference in Boston? Or, any other recent studies of Fraxel on acne scarring. I was told by Dr Zakia Rahman (Fraxels' medical consultant) that she would be presenting a paper on acne scarring, also in March. However, when I google, I never find any recent studies on Fraxel efficacy and protocols for acne scarring. I would love to read these papers.

My improvemnt to date is so subtle, that it is hard to get too excited, but I think it takes time. Moreover, my first treatment was a waste at such low energy levels, other than as a test to see if I could tolerate procedure. I am waffling between 23 and 25 for # 3. I guess your advice would be 25. My scars are shallow though, so I may be better off at 23 with more passes. The Laser Center I am going to is a big spa that has every laser imaginable (and is less expensive than in SF), but I don't think they have much experience with acne scarring, so I feel I need to be assertive on what is best for me. By the way, I am happy with my choice so far. To be honest, I don't think many people in CA have acne scarring, so maybe not that many places have expertise here.

 

Hi BillyBoy,

I have seen plenty of pdf documents on Fraxel efficacy and protocols for acne scarring. Do a google for fraxel and acne scaring. I spent at least a few hours searching through the results to find the links that were relevant to me. If your interested in Dr Zakia Rahman's presentation, you can find it on the fraxel website via the Physician education link then click on Webinars. Research is key in tailoring your treatment.

Total energy is really what counts, so 25 X 125 X 6 passes = 18750 is not as good as 23 x 125 x 8 passes = 23000. Bottom line, as long as you are being treated for your scars at energy level above 20mJ the total energy is what's important. Acne Scars require at least 20mJ to reach the depths of the dermis to stimulate the collagen to generate a noticable response. Aim for more passes and go for as many you can tolerate.

The down side is what I am experiencing at the moment. I went for a high number of passes and hence I'm still very red, there is a bit of scabing and my skin is very tender. I really pushed it with 25mJ at 6 passes and then another 6 passes at 30mJ. Not for the faint hearted. I have to question whether I can afford to increase on this in the next treatment. If so I would need to take more time of work as I don't feel I am presentable even 3 days after treatment.

Good luck,

Blaster

Blaster

You have been super helpful so please keep it up. That said, I had read the Fraxel website materials back in Jan and Feb before I decided to try Fraxel in early March. Also, maybe I am missing something but I don't find any authoritative papers by googling.

I keep finding the reference to a 40 patient study where 93% saw improvement after 3 months. I don't know if this was multicenter. Most importantly, they should have had a control group. In these studies it is best to have independent panel of experts evaluate the treated group vs. a non treated group. The evaluators would be blind, as the evaluations would be done well after symptoms subside. Also, they could have also tested another group with another modality such as Smoothbeam for comparatve efficacy. There should then be a scoring system as to before vs. after by both the panel and the subjects (the subjects evaluation would not be done for nontreated control group for obvisous reason that they know nothing happened).

Also, I could not locate any clinical data supportng which settings and the like are optimal. It seems very anecdotal to me.

While I believe in Fraxel, I wish I could locate something that would give me more confidence, especially as to an optimal treatment protocol.

Thanks again

Are any of you new fraxelers using topical retinoids while receiving your treatments? My doctor advised against this, but I know other fraxelers' doctors have not. I'm just curious as to what would happen if somebody were to get fraxel while using topical retinoids.

Are any of you new fraxelers using topical retinoids while receiving your treatments? My doctor advised against this, but I know other fraxelers' doctors have not. I'm just curious as to what would happen if somebody were to get fraxel while using topical retinoids.

 

There was a fraxel trial for acne scarring in NYC awhile back. I couldnt do it cause I had used topical retinoids within 6 months. But I think that was more about them being able to establish efficacy (i.e. that improvement was due to fraxel and nothing else). Too bad as the treatments were free. Maybe they'll offer it again . . .

Does anyone know results of that study? Is it done? Some people on this thread were/are part of that trial . . .

Are any of you new fraxelers using topical retinoids while receiving your treatments? My doctor advised against this, but I know other fraxelers' doctors have not. I'm just curious as to what would happen if somebody were to get fraxel while using topical retinoids.

 

My dr. also advised against it. They said not to use it at least 2 weeks before my first fraxel and then throughout the treatments and a month afterwards. When I used retin-a, my skin was a mess; dry, flaky and very red. Since this is similar to the reaction skin has while undergoing Fraxel treatments, I'd imagine that it would be a bad idea to combine the two. Too much for my poor skin to take at one time. However, everyone reacts differently. Some people might be able to tolerate it. The guidelines for Fraxel treatments are still murky at best. My dr. also says not to take ibuprofen during the treatments....but I can take Tylenol. Not quite sure why, I've noticed that other posters have taken it during treatments.

Just had # 3 at 25mj, 125 density and 8 passes. I am really hot and swollen.

Anyway, Dr Zakia Rahman (principal clinical investigator of Fraxel) recommends against topical retinoids in her training programs for prior 2 weeks because she beleives it blunts the Heat Shock Response to laser radiation. My doc suggests that I start Retin A 1 week after treatment to speed healing and then stop after 1 week so that I have the 2 week abstinence before next one, which is my last by the way.

I made mistake of not stopping Naproxen, which is NSAID like Ibuprophen, so I had mucho pin point bleeding today. NSAIDs thin blood leading to more bleeding. That's why your doc would prefer aceteminophen over a NSAID

I just had my first session of Fraxel and the blue dye won't come off. Any ideas how to take the dye of faster?

I just had my first session of Fraxel and the blue dye won't come off. Any ideas how to take the dye of faster?

 

Soak a soft handtowel in ice cold water, wring it out and put it on your face. After several minutes, gently dab off dye -- do not rub. Repeat this process. I was also told that jojoba oil may be more effective than the burn cream they give you to put on. Anyway, I didn't do the cold wet towels for most of the first day and hardly any dye came off. But I did the cold wet towels a ton the next morning and it came off really fast. But be gentle!!

I also foudn the cold towels very soothing -- helped take down the redness a lot.

Facial cleanser didn't do anything (when I took a shower).

Heavy burn creams didn't do much other than clog my pores.

But the cold, wet towels worked the best. But they must be COLD WET towels, not ice.

But don't put ice directly on your skin.

 

I just had my first session of Fraxel and the blue dye won't come off. Any ideas how to take the dye of faster?

 

Soak a soft handtowel in ice cold water, wring it out and put it on your face. After several minutes, gently dab off dye -- do not rub. Repeat this process. I was also told that jojoba oil may be more effective than the burn cream they give you to put on. Anyway, I didn't do the cold wet towels for most of the first day and hardly any dye came off. But I did the cold wet towels a ton the next morning and it came off really fast. But be gentle!!

I also foudn the cold towels very soothing -- helped take down the redness a lot.

Facial cleanser didn't do anything (when I took a shower).

Heavy burn creams didn't do much other than clog my pores.

But the cold, wet towels worked the best. But they must be COLD WET towels, not ice.

But don't put ice directly on your skin.

 

GREAT! Thank you! I will try this first thing in the morning. Thanks again. 🙂

Dawn dishwashing soap (with lots of cold water) is the optimal solvent for the dye. I'm surprised your doc did not use this and then maybe even give you a small cup to take home.

I just had my first session of Fraxel and the blue dye won't come off. Any ideas how to take the dye of faster?

 

Try using dishsoap and very cold ice water. It will be a gradual process, you might have to do it many times to fade the blue rather than removing it all at once. Don't scrub, but you can use a gentle washcloth. Also, if you have any sort of cold cream type topical, try putting it on your face, laying cold washclothes over it and letting it sit for 10 minutes or so. It will come off eventually....;)

I just had my third fraxel today so I'm right there with you. It gets easier to get through, the first one is by far the worst.